Overnight Health: Trump still pushing for ObamaCare mandate repeal in tax bill | Tax bill eliminates medical expense deductions | House votes to repeal Medicare cost-cutting board | Patrick Kennedy says $100B needed to fight opioids

Overnight Health: Trump still pushing for ObamaCare mandate repeal in tax bill | Tax bill eliminates medical expense deductions | House votes to repeal Medicare cost-cutting board | Patrick Kennedy says $100B needed to fight opioids
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GOP tax bill would eliminate medical expense deductions

The House Republican tax bill unveiled Thursday would eliminate the ability for individuals to deduct qualified medical expenses, a provision that could have major implications for households with extremely high health-care costs.

Under current law, the IRS allows individuals to deduct qualified medical expenses that exceed 10 percent of a person's adjusted gross income for the year. The bill would repeal that itemized deduction, effective in 2018.

The cost to repeal the medical expense deduction is about $10 billion per year.

The IRS currently allows individuals to deduct preventative care, treatment, surgeries and dental and vision care as qualifying medical expenses.

The medical expense deduction can also be used for long-term care expenses for chronically ill patients.

The provision could be a flashpoint for Republicans, as the repeal could hit both patients themselves and their families, who sometimes help pay for care.


One item missing from the tax bill was language repealing ObamaCare's individual health insurance mandate, something President Trump has pushed for. More on that below...


Trump not giving up on mandate repeal in tax bill

President Trump told House Republicans in a meeting Thursday that he still wants to repeal ObamaCare's individual mandate in tax reform, perhaps in the Senate, according to two lawmakers in attendance.

"He just said he liked the idea and he had asked the senators about it and they said they were considering it," said Rep. Kristi Noem (R-S.D.), who was in attendance at the meeting of House leaders and Ways and Means Committee members with Trump at the White House.

Trump on Wednesday tweeted that he wanted to repeal the mandate, which requires people to have health insurance or pay a fine, as part of tax reform.

But House Ways and Means Chairman Kevin BradyKevin Patrick BradyRyan pledges 'entitlement reform' in 2018 Senate approves motion to go to tax conference Overnight Finance: GOP delays work on funding bill amid conservative demands | Senate panel approves Fed nominee Powell | Dodd-Frank rollback advances | WH disputes report Mueller subpoenaed Trump bank records MORE (R-Texas) has previously rejected the idea, worrying it would jeopardize the tax measure, and the provision did not make it into the tax bill released Thursday.

Trump is now looking to the Senate to possibly include it, though.

Noem said lawmakers in the room did not respond to Trump's idea, which she said he did not discuss at length. "A couple of us that had wanted it kind of glanced at each other, like it is a good idea," she said.

Sen. Tom CottonTom CottonGOP and Dems bitterly divided by immigration Grassley offers DACA fix tied to tough enforcement measures Five things senators should ask Tom Cotton if he’s nominated to lead the CIA MORE (R-Ark.) has been pushing the idea in the Senate. Senate Finance Committee Chairman Orrin HatchOrrin Grant HatchMcConnell names Senate GOP tax conferees Ryan pledges 'entitlement reform' in 2018 Utah governor calls Bannon a 'bigot' after attacks on Romney MORE (R-Utah) has not ruled the idea out, but he has said that he wants to keep health care measure separate from tax reform.

Read more here.


More on the tax bill

Winners and losers in the GOP tax bill

Republicans launch sales pitch for tax bill

How the GOP handled several thorny tax issues

Read the 429-page bill here


House votes to repeal ObamaCare's Medicare cost-cutting board

The House on Thursday voted to repeal a controversial Medicare cost-cutting board that has drawn the ire of both parties.

Lawmakers voted 307-111 to abolish what is known as the Independent Payment Advisory Board (IPAB). The board is tasked with coming up with Medicare cuts if spending rises above a certain threshold but has been criticized as outsourcing the work of Congress.

It has also been the target of the false attacks from ObamaCare opponents that the board enables unelected bureaucrats to helm "death panels."

The bill now moves to the Senate, but it's not likely the upper chamber will act before the end of the year. Even then, Republicans may not get the 60 votes needed to pass it as a stand-alone bill.

Nobody has been appointed to the panel and budget experts have estimated they don't expect IPAB to be triggered until 2021 or 2022. Democrats say Congress has the authority to overrule any recommendations the panel could make.

This was not the first time the House has tried to get rid of the panel; they've been trying since 2012, but it is the first attempt with a Republican in the White House. It's also the first vote since congressional Republicans failed to abolish IPAB as part of a larger ObamaCare repeal earlier this year.

The White House on Wednesday signaled support for the bill, noting in a statement that IPAB repeal was part of President Trump's budget request.

Read more here.


Patrick Kennedy: At least $100 billion needed to fight opioids

Former Rep. Patrick Kennedy, a member of the president's opioid commission, is calling for a robust infusion of federal funds to combat the opioid epidemic, to the tune of $100 billion over 10 years.

In an interview with The Hill, Kennedy stressed he views that dollar figure "just as a starting point, at a minimum, minimum, minimum."

His comments came a day after the release of a 131-page report from President Trump's six-member opioid commission that detailed 56 recommendations on how to curb the crisis. The document called for Congress to appropriate "sufficient funds" for the effort but didn't name a specific dollar amount.

"It is not the Commission's charge to quantify the amount of these resources, so we do not do so in this report," the report states. "The Commission urges Congress to respond to the President's declaration of a public health emergency and fulfill their constitutionally delegated duty and appropriate sufficient funds to implement the Commission's recommendations."

Yet, Kennedy was clear that an appropriation must come in the form of billions of dollars, and at Wednesday's opioid commission meeting, he mentioned a minimum of $10 billion at the national level -- comments he expanded upon to The Hill.  

Read more here.


Dems warn against cutting ObamaCare fund to pay for children's health program

Senate Democrats warned Republican leadership Thursday against cutting ObamaCare's public health fund to pay for an extension of the popular Children's Health Insurance Program (CHIP).

A bill the House is expected to pass this week to extend funding for CHIP would pay for it through cuts to ObamaCare's Prevention and Public Health Fund (PPHF).

But 22 Senate Democrats, led by Sen. Edward MarkeyEdward (Ed) John MarkeyNet neutrality supporters predict tough court battle over FCC's repeal plan Avalanche of Democratic senators say Franken should resign Driverless car bill hits Senate speed bump MORE (Mass.), warned Thursday they wouldn't support those offsets in the upper chamber.

"Using the PPHF as a piggy bank, even for important health programs, will result in major cuts to state, local, tribal, and territorial health departments, as well as other grantees working at the local level," the Democrats wrote in a letter to Senate leadership.

Democratic support is crucial to passing CHIP in the Senate, where it would need at least 60 votes. Republicans only have a 52-seat majority.

Democrats warn that the cuts to the public health fund could result in the elimination of programs like anti-smoking efforts and programs to immunize children.

Read more here.


Blue Dog Dems back bipartisan health bill

A group of centrist Democrats on Thursday endorsed the Senate's bipartisan plan to shore up ObamaCare's insurance markets.

The Blue Dog Coalition, a group of 18 centrist Democrats, hopes its support could build momentum to create a similar bill in the House.

"This endorsement is a call to action in the House to develop a bill that mirrors the Alexander-Murray health care legislation and bring it to the floor for full consideration," said Rep. Daniel Lipinski (D-Ill.), Blue Dog co-chair for policy.

"The American people are counting on us to move quickly to limit the negative effects of the President's executive order to cut funding for cost sharing reduction payments. They deserve peace of mind when it comes to health insurance costs and access to good health care."

The Senate bill, sponsored by Sens. Lamar AlexanderAndrew (Lamar) Lamar AlexanderOvernight Finance: Trump says shutdown 'could happen' | Ryan, conservatives inch closer to spending deal | Senate approves motion to go to tax conference | Ryan promises 'entitlement reform' in 2018 Senate approves motion to go to tax conference House conservatives, Ryan inch closer toward spending deal MORE (R-Tenn.) and Patty MurrayPatricia (Patty) Lynn MurrayDemocrats turn on Al Franken VA slashes program that helps homeless veterans obtain housing: report The Hill's 12:30 Report MORE (D-Wash.), would fund ObamaCare's insurer payments, called cost sharing reduction payments, for two years in an effort to stabilize the markets.

It would also provide states more flexibility to change the ObamaCare requirements.

But the bill still faces an uphill battle to becoming law. While it appears to have the support needed to pass the upper chamber, Senate Majority Leader Mitch McConnellAddison (Mitch) Mitchell McConnellGOP strategist donates to Alabama Democrat McConnell names Senate GOP tax conferees Brent Budowsky: A plea to Alabama voters MORE (R-Ky.) has said he won't call it for a vote without approval from President Trump.

Read more here.


From The Hill's opinion pages:

There's still time to repeal, replace ObamaCare's Medicare board

Spring promises of partnership on health-care reform is growing cold for states


State by state

Minnesota at risk for another measles outbreak, health official warns (Minnesota Public Radio)

Premature birth rates are rising in California after years of decline (Sacramento Bee)

Wisconsin Assembly approves bill blocking state health plans from covering abortion (The Capital Times)


What we're reading

Hospital groups to sue CMS over $1.6 billion cut to 340B program (Modern Healthcare)

Federal notices about ACA enrollment season get cut in number and messaging (The Washington Post)

Health care enrollment counselors facing stiff challenges (Associated Press)


The Hill event

Join The Hill on Tuesday, November 7, for America's Opioid Epidemic: Strategies for Prevention featuring FDA Commissioner Scott Gottlieb and Sen. Jeanne ShaheenCynthia (Jeanne) Jeanne ShaheenDems demand Tillerson end State hiring freeze, consult with Congress The Hill Interview: GOP chairman says ‘red flags’ surround Russian cyber firm Schumer celebrates New York Giants firing head coach: ‘About time’ MORE (D-N.H.). Topics of conversation include the response to the opioid crisis, prevention initiatives, and the role education might play in lowering addiction rates. 


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Follow us on Twitter: @thehill@jessiehellmann@PeterSullivan4@rachel_roubein, and @NateWeixel.